During our week in Mombin Crochu, 208 patients were seen by Dr. Gayle in the Medical Clinic, in addition to the patients seen by Dr. Joanne Vincent. There were also 30 surgeries performed:

• Incarcerated abdominal wall hernia (1)
• Mass removal (9) (Including a 27x13.5x3 cm mass)
• Breast Bx (1)
• Inguinal herniorraphy (11)
• Inguinal herniorraphy/hydrocoelectomy (5)
• Skin Graft (1)
• Wound debridement (1)
• Orchiectomy for torsion and treatment of septic shock (1)

We had no immediate complications.

From an organizational standpoint, the hospital continues to improve each time we visit. Dr. Joanne Vincent is doing an excellent job, in spite of many difficulties, in delivering care to these desperately poor people.

The public health aspect continues to grow and is supported by MSH, who made a visit while we were there. There are programs for education, prenatal care, and vaccinations for the children that continue to expand to outlying areas.

The internal affairs of the hospital seem to be improving as well with improved nursing care and record keeping. A system for a more efficient flow of patients in the clinic has also been developed.

The nurses and all ancillary personnel were extremely helpful in preparing the patients for surgery and helping to care for them afterwards, which is not part of their routine. They were included in the OR procedures as well.

Teaching was done as much as possible, and we plan to expand this aspect on our return visit in the fall, for we feel this is an extremely important part of the mission.

All of this was done by the hospital personnel in spite of a lack of payment for many months. This must be reconciled. This has made it much more difficult for Dr. Joanne to do her job, and the fact that the hospital is even open is a testament to her abilities.

The physical plant is in great need of repair and maintenance, and I would recommend that several groups be encouraged to go to the hospital to teach the personnel how to do this, and to fix the existing problems with the buildings. Painting, structural repair and upkeep are necessary or the buildings will continue to deteriorate.

The roads remain an obstacle to reaching the hospital, and emphasis on improvement should continue to be made to the government.

Overall the hospital continues to improve and to grow, with improvement in the transitional aspect since our last visit in September 2006. The patients are cared for very well, and the personnel are dedicated to the hospital.

The Medical Director is doing an outstanding job, and continues to gain her strength from God and to use her faith to guide her during difficult times. Her husband is in PAP in school and she is alone there with her child. Her courage and strength are a testimony to her belief that she is at the hospital because God has called her and Dr. Kens to serve here, in spite of the difficulties.

This was one of the most fulfilling trips that I have experienced in the 11 years I have been going to the hospital. It is so wonderful to see the growth of the hospital, the care the patients receive, the desire of the personnel to learn and the dedication they show, and the continual improvements as the Haitian people take pride in and ownership of the hospital.

Continued support is necessary for this progress to continue, and I strongly recommend that great emphasis on fundraising for this faith-based program continue through CHN and MBF. Without this the progress that has been made, and the continued care for these people with such need, will be extremely difficult.